Clinical question
Compared with placebo or usual care, how effective are exercise programmes in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication (IC)?
Bottom line
High-quality evidence showed exercise therapy played an important part in the care of selected patients with IC, improving pain-free walking times and distances. Effects were demonstrated following 3 months of supervised exercise, although some programmes lasted longer than 1 year. Limited data suggested an effect was sustained for up to 2 years. Exercise did not improve ankle brachial index, and there were no differences in the effect of exercise between groups in terms of amputation or mortality. Exercise might improve quality of life when compared with placebo or usual care.
Caveat
Evidence presented in this review was of moderate to high quality. Comparisons of exercise with antiplatelet therapy, pentoxifylline, iloprost, vitamin E, and pneumatic foot and calf compression were limited because numbers of identified trials and of participants were small.
Context
People with mild to moderate IC are advised to keep walking, stop smoking and reduce cardiovascular risk factors. Other treatments include antiplatelet therapy, pentoxifylline, iloprost, cilostazol, vitamin E, pneumatic foot and calf compression, angioplasty and bypass surgery.
Cochrane Systematic Review
Lane R et al. Exercise for intermittent claudication. Cochrane Reviews, 2017, Issue 12. Art. No.: CD000990.DOI: 10.1002/14651858. CD000990.pub4. This review contains 32 studies involving 1835 participants.
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